Proteomic characterization of atopic dermatitis blood from infancy to adulthood

Journal of the American Academy of Dermatology
Open Access

Clinical Summary

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What was studied

Cross-sectional profiling of 375 serum proteins using an Olink platform in patients with moderate-to-severe atopic dermatitis across ages—infants (n=20), children (n=39), adolescents (n=21), adults (n=20)—versus 83 age-matched controls.

Key findings

Across ages, a shared Th2 signature (e.g., CCL13/CCL17) was present and intensified with age; infants showed Th1 down-regulation (e.g., CXCL10) and unique upregulation of innate/Th17 proteins (e.g., IL‑17C, IL‑1RN, CCL19, PI3), while Th1 products (IFN‑γ/CXCL9/CXCL10/CCL2) increased from childhood through adulthood; adults uniquely upregulated cardiovascular/coagulation/diabetes-related proteins (e.g., PLAUR, MPO, ADAMTS13, SERPINE1, SELE; FDR <0.01). Up to 228 differentially expressed proteins were identified; IL‑16 and PI3 correlated with AD severity (SCORAD) across ages (r >0.4; P <.01), and age correlated with CCL17/TARC, PI3, and IL‑16 (r >0.43; P <.001).

Study limitations

Single time-point, cross-sectional design; cohort was predominantly Caucasian, which may limit generalizability.

Clinical implications

Systemic immune signatures in atopic dermatitis are age-specific beyond shared Th2 activation; consider patient age when interpreting blood biomarkers and designing studies, noting early systemic inflammation in infants and cardiovascular protein upregulation in adults.